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Indications

• This medication is an estrogen hormone used by women to alleviate menopausal symptoms like hot flashes and vaginal dryness, which result from reduced estrogen production in the body.
• If the medication is used to treat symptoms only in and around the vagina, consider products applied directly inside the vagina before medications taken orally, absorbed through the skin, or injected.
• Some estrogen products may be used by women after menopause to prevent bone loss (osteoporosis). However, alternative medications such as raloxifene, bisphosphonates including alendronate, may also effectively prevent bone loss and could be safer. These alternatives should be considered before estrogen treatment.
• Certain estrogen products may be used by both men and women to treat specific cancers (such as certain types of prostate cancer, and breast cancer that has spread to other parts of the body). Additionally, women who cannot produce enough estrogen due to conditions like hypogonadism or primary ovarian failure may use these products.

Dosage and administration

• Before starting this medication, read the Patient Information Leaflet from your pharmacist. If you have any questions, consult your doctor or pharmacist.
• Take this medication orally, with or without food, as directed by your doctor. To prevent stomach upset, you can take it with food or right after a meal.
• If you are using extended-release tablets, do not crush, chew, or dissolve them. Swallow the tablets whole to avoid releasing the entire dose at once, which can increase the risk of side effects.
• The dosage is determined by your medical condition and response to treatment.
• Take the medication regularly to maximize its benefits. To help you remember, take it at the same time(s) each day as directed. Follow your dosing schedule carefully. Do not increase the dose or take the medication more frequently or for a longer duration than directed.
• Inform your doctor if your condition does not improve or worsens.

Side effects

• Possible side effects of this medication include stomach upset, nausea/vomiting, bloating, breast tenderness, headache, or weight changes. If any of these effects persist or worsen, inform your doctor or pharmacist promptly.
• Notify your doctor promptly if you observe the tablet in your stool.
• This medication is prescribed because your doctor has determined that the benefits outweigh the risks of potential side effects. Many individuals using this medication do not experience serious side effects.
• Report immediately to your doctor any serious side effects, such as nausea/vomiting that doesn’t stop, mental/mood changes (such as depression, memory loss), breast lumps, unusual vaginal bleeding (spotting, breakthrough bleeding, prolonged/recurrent bleeding), increased or new vaginal irritation/itching/odor/discharge, severe stomach/abdominal pain, yellowing eyes/skin, dark urine, swelling hands/ankles/feet, or increased thirst/urination.
• Rarely, this medication may cause serious problems from blood clots (e.g., heart attacks, strokes, deep vein thrombosis, pulmonary embolism). Seek immediate medical help if you experience chest/jaw/left arm pain, unusual sweating, sudden/severe headache, weakness on one side of the body, confusion, trouble speaking, sudden vision changes (partial/complete blindness), pain/redness/swelling of legs, tingling/weakness/numbness in the arms/legs, trouble breathing, coughing up blood, or sudden dizziness/fainting.
• Although a very serious allergic reaction is rare, seek immediate medical help if you notice symptoms such as rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing.
• This list does not cover all possible side effects. Contact your doctor or pharmacist if you observe other effects not mentioned here.

Precautions

• Inform your doctor or pharmacist about any allergies before taking the medication; inactive ingredients may cause allergic reactions.
• Disclose medical history, including vaginal bleeding, cancers, blood clots, heart disease, liver/kidney disease, family medical history, swelling disorders, blood clotting disorders, high blood pressure, diabetes, obesity, lupus, thyroid issues, mineral imbalance, hormone problems, uterus problems, gallbladder disease, asthma, seizures, migraines, or blood disorders.
• Avoid smoking or tobacco use while taking the medication, as it increases the risk of stroke, blood clots, high blood pressure, and heart attack.
• Inform your doctor of recent or upcoming surgery or prolonged immobility, as it increases the risk of blood clots; special precautions may be necessary.
• This medication may cause melasma (dark spots on the face); limit sun exposure, avoid tanning booths, use sunscreen, and wear protective clothing.
• Nearsightedness or contact lens wearers may experience vision problems; contact your eye doctor if issues arise.
• Children may be more sensitive to side effects, affecting growth/development; discuss potential effects with the doctor and monitor growth periodically.
• Do not use the medication during pregnancy; inform your doctor immediately if you become pregnant or suspect pregnancy.
• The medication passes into breast milk, potentially reducing its quality and amount; consult your doctor before breastfeeding.